Mulheres de Bairros Populares em Caxias-MA: Vidas que (Re)Existem / Women From Low-Income Neighborhoods in Caxias-MA: Lives that Exist / Mujeres de Barrios Populares de Caxias-MA: Vidas que (Re) Existen

O presente estudo parte das experiências das mulheres nos bairros populares de uma cidade do interior do Maranhão, Caxias. Objetivou-se conhecer as histórias de vida das mulheres desses bairros, os seus modos de vida e resistência em suas vivencias diárias. Trata-se de uma pesquisa qualitativa que tem como base a produção de sentido no cotidiano. Participaram cinco mulheres de quatro bairros populares do município. Foram utilizadas a observação no cotidiano, conversas no cotidiano e entrevista semiestruturada. Para a análise foi utilizado o mapa dialógico de produção de sentidos. Percebeu-se que as mulheres atuam enquanto sujeitas ativas em seus bairros buscando por melhores condições de vida, em prol de educação e infraestrutura, a partir da formação de uma rede de sociabilidade e solidariedade, à frente de clube de mães, associação de moradores e grupo de dança enquanto formas de resistência. Logo, entende-se que esse estudo pode contribuir com a literatura e discussões sobre mulheres de contextos periféricos de regiões não metropolitanas.

The present study is based on the experiences of women from the low-income neighborhoods of Caxias, a country town in the Brazilian State of Maranhão. The purpose was to investigate the life stories of women who live in that neighborhoods, their ways of life, and resistance in their daily experiences. This is a qualitative research that is based on the production of meaning in everyday life. We have researched five women from four low-income neighborhoods in the city through daily observation, daily conversations, and semi-structured interviews. We have used the dialogic map of production of meaning for this analysis. It was noticed that women act as active subjects in their neighborhoods, looking for better living conditions towards education and infrastructure. They do it building a network of sociability and solidarity which includes a front of mothers' club, community association, and dance group as forms of resistance. Therefore, we realize that this study can contribute to the literature and to the discussion about women from peripheral contexts of non-metropolitan regions.

El presente estudio se basa en las experiencias de mujeres en los barrios populares de una ciudad del interior de Maranhão, Caxias. El objetivo fue conocer las historias de vida de mujeres que viven en barrios populares de Caxias do Maranhão, sus formas de vida y resistencia en sus experiencias cotidianas. Se trata de una investigación cualitativa que se fundamenta en la producción de sentido en la vida cotidiana. Participaron cinco mujeres de cuatro barrios populares de la ciudad. Se utilizó la observación diaria, conversaciones diarias y entrevistas semiestructuradas. Para el análisis se utilizó el mapa dialógico de producción de sentido. Se percibió que las mujeres actúan como sujetos activos en sus barrios buscando mejores condiciones de vida, a favor de la educación e infraestructura, a partir de la formación de una red de sociabilidad y solidaridad, al frente del club de madres, asociación de vecinos y grupo de baile como formas de resistencia. Por lo tanto, se entiende que este estudio puede contribuir a la literatura y discusiones sobre mujeres de contextos periféricos de regiones no metropolitanas.

Poverty related diseases amongst Malaysia’s low-income community: a review

@#Poverty, as proven by several studies, is a driving force behind poor health and hygiene practices. This review attempts to outline common communicable and non-communicable diseases that disproportionately affect Malaysia’s 2.91 million low-income households. The current study also looks into the government’s housing and healthcare programmes for this demographic to improve their health and well-being. The initial examination yielded incredibly little research on this marginalised community, with event reporting typically generalised to the Malaysian community as a whole rather than analysing disease incidences based on household income, which would better reflect povertydriven diseases. As a result, there is an acute need for more accurate information on the epidemiology of diseases among the poor in order to address this public health issue and provide conclusions that can drive policy designs.

Ethiopian Health Extension Workers' Training Status and Perceived Competency

BACKGROUND: Training and work experience are critical inputs for delivering quality health services. However, no nationwide assessment has been conducted on the status of training and the competency of Health Extension Workers (HEWs). Therefore, this study aimed to assess HEWs' pre service training status and perceived competency in Ethiopia. METHODS: The study was conducted in all regions and all HEWs training institutions in Ethiopia. We used cross sectional study design with a mixed method approach that included 585 HEWs, 1,245 HEW trainees, 192 instructors, and 43 key informants. Descriptive statistics and thematic analysis were used to analyse quantitative and quantitative data respectively. RESULT: Twenty-six percent of the HEWs said that they were competent to deliver all the HEP activities, and 73% of the HEWs said that they could confidently deliver 75% of the HEP activities. Receiving in-service training and having level III/IV qualifications are positively associated with the competency of HEWs. Similarly, HEP trainees perceived themselves as highly competent in executing their professional work, except in using computer and mobile health technology. Both instructors and trainees rated the quality of the curriculum and course materials positively. However, basic services and facilities in most training institutions were perceived to be inadequate. Additionally, individual learning, problem-solving, case-analysis, and assessment methods such as project work and portfolios were rarely practiced. CONCLUSIONS: Although the perceived competence of HEW trainees is high, the HEWs' training is not provided as per the curriculum because of limited resources. All the necessary resources should be made available to produce competent HEWs

Depression and Burnout among Health Extension Workers in Ethiopia: A Cross-Sectional Study

BACKGROUND: Depression and burnout are common among healthcare workers (HCWs) and negatively affect their well being and the quality of the service they provide. However, the burden of depression and burnout among health extension workers (HEWs) in Ethiopia and their relationship has not been documented well. The objective of this study was to estimate the prevalence of depression and burnout among HEWs in Ethiopia and to investigate the relationship between these conditions. MATERIALS AND METHODS: We used a cross-sectional study design and collected data from 584 rural and 581 urban HEWs in Ethiopia, as part of the 2019 national health extension program assessment. The Patient Health Questionnaire (PHQ-9) and Burnout Self-Test were used to screen HEWs for depression and burnout, respectively. We used descriptive statistics to estimate the magnitude of depression and burnout, and logistic regression to examine their relationship. RESULT: Based on PHQ-9 cutoff scores of 10, the prevalence of major depression was 16.5% among rural and 8.9% among urban HEWs, whereas burnout risk was 39.8% among rural and 12.6% among urban HEWs. The odds of having depression among HEWs with burnout risk was relatively higher compared to those without burnout risk [For rural HEWs, the adjusted odds ratio (AOR) is 11.88 at a 95% confidence interval (CI; 5.27, 26.80), and for urban HEWs, the AOR is 11.49 at a 95% CI (5.35, 24.63)]. CONCLUSION: The prevalence of depression and burnout is high among HEWs in Ethiopia, with a significant rural­urban difference, and burnout is a significant predictor of depression. Mental health interventions that enable prevention, early detection, and management are needed especially for rural HEWs who are in charge of preventive health service delivery for the disadvantaged rural communities

Association between Socio-demographic Factors, Involvement Status in Gardening and Diet Quality among B40 Households in Taman Keramat, Kuala Lumpur

@#Introduction: COVID-19 pandemic has impacted the livelihood of Malaysians and gardening activities have contributed positively to the diet quality. This study aimed to determine the factors associated with diet quality among adults in AU2 Keramat, Kuala Lumpur. Methods: The cross-sectional study involved adults aged 18 to 59 via convenience sampling. The socio-demographic, physical activity level and involvement status in gardening were obtained through a questionnaire, while food intake was from a single-day 24-hour diet recall. The diet quality was determined through Malaysian Healthy Eating Index (MHEI) and dietary misreporting was calculated using the Goldberg cut-off method. Results: A total of 117 respondents (65.8% females, 35.2% males) with a mean age of 40.98 were involved in this study. Findings showed that most respondents did not engage in gardening activities (72.6%) and the prevalence of poor diet quality in this study was 89.7%, with a mean score of 44.51. The older respondents (r= 0.20, p= 0.034) and community gardeners (t= -2.63, p= 0.011) had a significantly higher diet quality but not home gardeners (t= 0.12, p= 0.902). The respondents involved in gardening activity also had a significantly higher fruit serving intake, Mann-Whitney U= 1045.00, p= 0.036) and lower total fat intake (t= 2.27, p= 0.025). Conclusion: The diet quality of the respondents remains poor but community gardeners had significantly higher diet quality and fruit intake while lower total fat intake. Interventions need to be developed to address the persistent poor diet quality of adults in the community.

Percepções de mães pobres acerca das práticas de monitoria positiva e negativa / Perceptions of impoverished mothers on positive and negative monitoring practices

O objetivo do presente estudo foi descrever a percepção de mães em situação de pobreza residentes na região metropolitana de Belém-PA sobre suas práticas de monitoria positiva e monitoria negativa. Participaram deste estudo 13 cuidadoras, que além de responderem à instrumentos para coleta de dados sociodemográficos (ISD), de pobreza familiar (IPF) e de avaliação de práticas parentais (IEP), participaram de grupos focais. As participantes foram divididas de acordo com o nível de pobreza familiar em dois grupos: mais pobres e menos pobres. As etapas de coleta dos dados foram realizadas em Centros de Referência em Assistência Social (CRAS) do município de Belém-PA, localizados em áreas periféricas da cidade e em salas de aula do Núcleo de Teoria e Pesquisa do Comportamento (NTPC). A análise qualitativa dos dados ratificou a relação entre maiores níveis de privação com a maior probabilidade de utilização de monitoria negativa. Os resultados apontam para os desafios e demandas do contexto de vulnerabilidade que enfraquecem a habilidade de exercer uma parentalidade efetiva.

The objective of this study was to describe the perception of poor mothers living in the metropolitan region of Belém-PA, about their practices of positive and negative monitoring. Participated in this study 13 guardians who, in addition to responding to the following quantitative instruments: ISD (sociodemographic inventory), IPF (family poverty index) and IEP (parenting styles inventory), participated in a focus group. Participants were divided according to the level of family poverty into two groups, namely, more and less poor. The data collection stages were respectively carried out in Social Assistance Reference Centers (Centros de Referência em Assistência Social - CRAS), located in peripheral areas of the city of Belém-PA and in classrooms of the Behavior Theory and Research Nucleus (NTPC). The qualitative data analysis confirmed the relationship between higher levels of deprivation and higher probabilities of negative monitoring. The results point to the challenges and demands of the vulnerability context that weaken the ability to exercise positive parenting.

Establishing communities of practice to improve health policy, systems and reproductive, maternal, newborn, child and adolescent health in West Africa

Objectives: To explore and analyse factors that facilitate and inhibit the initiation and functioning of a national and transnational Community of Practice (CoP) for health policy and systems (HPS) and Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) in West Africa and to identify lessons for CoP interventions in similar multilingual low and middle-income contexts. Design: A case study, with the case defined as processes, enablers and barriers to the initiation and functioning of a national and transnational CoP for HSP and RMNCAH in West Africa and drawing on a review and analysis of secondary data from the program, workshop, country team and project reports, and training sessions. Setting: The Economic Community of West African States (ECOWAS). Participants: Professionals from two Anglophone (Ghana and Sierra Leone) and four Francophone (Burkina Faso, Cote d'Ivoire, Niger e Senegal) ECOWAS countries. Interventions: Training and mentoring of multi-disciplinary country teams supported by small research grants to undertake formative evaluation and advocacy of priority HPS and RMNCAH issues; support for CoP development within and across country teams. Results: The desire to learn from peers and mentors was a major enabler of the process. Human and financial resource availability, competing demands for time, communication in the context of a Francophone-Anglophone official language divide and the arrival of COVID-19 were all constraints. Conclusions: This study highlights the processes, achievements, and challenges of establishing country-level and transnational CoPs in West Africa. CoPs require sustained human and financial resource investments, communication and medium-to-long-term implementation support for sustainability and impact.

Life purpose and sibling care in adolescence: possible associations / Projetos de vida e cuidado entre irmãos na adolescência: possíveis associações

The aim of this study was to investigate the possible relations between sibling care level and the areas of interest in adolescents' life purposes. Participants were 113 adolescents. The instruments were a record of socio-demographic data, the household tasks and Sibling Care Questionnaire, and a written testimony on life purpose. We identified 347 life projects, which were grouped into the following categories: career, family, possessions, happiness, and generosity. The results of the Pearson's correlations indicated positive associations between sibling care and generosity and career. Thus, there is a tendency that adolescents who take care of their younger siblings have more life projects related to assisting the family of origin and to professional development. These results suggest that taking care of younger siblings may influence the areas of interest of adolescents' life purposes.

O objetivo deste estudo foi investigar se há relação entre nível de cuidado dos irmãos maiores para com os menores e as áreas de interesse dos projetos de vida de adolescentes. Cento e treze adolescentes participaram do estudo. Para a avaliação foram utilizados uma ficha de dados biossociodemográficos, o Questionário de Tarefas Domésticas e de Cuidado entre Irmãos e um depoimento escrito sobre projetos de vida. Computaram-se 347 projetos de vida, os quais foram agrupados nas categorias: carreira, família, bens materiais, felicidade e generosidade. Os resultados das correlações de Pearson indicaram associações positivas entre cuidado e as áreas generosidade e carreira. Dessa forma constatou-se uma tendência de que os adolescentes que cuidam mais de seus irmãos mais novos elaborem mais projetos de vida relacionados a ajudar a família e ao desenvolvimento profissional. Esses resultados sugerem que cuidar de irmãos menores pode influenciar nas áreas de interesse dos projetos de vida dos adolescentes.

Domestic violence and risk of internalizing and externalizing problems in adolescents living with relatives displaying substance use disorders / Violência doméstica e risco de problemas de internalização e externalização em adolescentes com familiares apresentando transtornos por uso de substâncias

OBJECTIVE: To investigate the association between exposure to domestic violence and increased risk of internalizing and externalizing problems and substance use among adolescents living with relatives with substance use disorder (SUD) at a low-income community of São Paulo, Brazil. METHODS: A crosssectional study was conducted with 102 adolescents aged 12-17 years (M = 14.2, SD = 1.7) who were living with relatives suffering from SUD. Outcomes were measured using the Youth Self-Report (YSR), psychosocial stress factors questionnaire, Drug Use Screening Inventory (DUSI) and Phrase Inventory of Intrafamily Child Abuse (PIICA). RESULTS: The sample presented high prevalence of emotional/behavioral problems with YSR's scores in the clinical range for Internalizing Problems (24.5%), Externalizing Problems (21.6%), and Total Problems (26.5%). The presence of mental health problems predicted substance use (PR = 2.22; 95% CI = 1.2-4.13), and substance use predicted increased risk of mental health problems. Alcohol use predicted more than double the risk of emotional/behavioral problems (PR = 2.01; 95% CI = 1.08-3.76), while illicit drug use was associated with an almost threefold increase in the prevalence of Internalizing (PR = 2.87; 95% CI = 1.19-6.89) and Externalizing Problems (PR = 3.3; 95% CI = 1.35-8.04). CONCLUSION: Adolescents of relatives with SUD are at risk of developing emotional and behavioral problems. These findings reinforce the need to develop public mental health policies, which include protective interventions to adolescents living in families affected by substance use disorders.

OBJETIVO: Investigar a associação entre exposição à violência doméstica e aumento do risco de problemas internalizantes e externalizantes e uso de substâncias entre adolescentes que vivem em famílias com transtorno por uso de substâncias (TUS) em uma comunidade de baixa renda de São Paulo, Brasil. MÉTODOS: Estudo transversal com 102 adolescentes de 12 a 17 anos (M = 14,2, DP = 1,7) que vivem com familiares com TUS. Os desfechos foram avaliados por meio do Inventário de Autoavaliação para Adolescentes (YSR), questionários de fatores de estresse psicossociais, Drug Use Screening Inventory (DUSI) e Inventário de Frases de Violência Doméstica (IFVD). RESULTADOS: A amostra apresentou altas taxas de problemas emocionais/comportamentais no YSR, sendo 24,5% com escores na faixa clínica para Problemas Internalizantes, 21,6% para Problemas Externalizantes e 26,5% para Problemas Totais. A presença de problemas de saúde mental foi preditora do uso de substâncias (RP = 2,22; IC 95% = 1,2-4,13) e o uso de substâncias foi preditor do aumento da prevalência de problemas emocionais/comportamentais. O uso de álcool prediz mais do que o dobro do risco de problemas emocionais/comportamentais (RP = 2,01; IC 95% = 1,08-3,76), enquanto o uso de substâncias ilícitas esteve associado com um aumento de quase três vezes na prevalência de Problemas Internalizantes (RP = 2,87; IC 95% = 1,19-6,89) e Externalizantes (RP = 3,3; IC 95% = 1,35-8,04). CONCLUSÃO: Adolescentes que convivem diretamente com familiares com TUS estão em risco para o desenvolvimento de problemas emocionais/comportamentais. Os achados reforçam a necessidade de políticas públicas que incluam programas de proteção para adolescentes que vivem em famílias com transtornos causados pelo uso de substâncias.

Características e demandas da população em situação de vulnerabilidade social acompanhadas em Belford Roxo (RJ) / Characteristics and demands of the population in a situation of social vulnerability attended in Belford Roxo (RJ)

RESUMO O objetivo deste estudo foi o descrever as características e demandas das famílias em acompanhamento no Centro de Referência de Assistência Social (Cras) de Santa Marta, município de Belford Roxo (RJ), no período de 2006 a 2017. Trata-se de estudo transversal descritivo com dados extraídos das fichas de acompanhamento. Um total de 87 famílias foi acompanhada no período. A maioria dos responsáveis familiares era do sexo feminino (92,0%), menor de 40 anos (59,8%), solteira (92,0%) e com ensino fundamental incompleto (89,7%). As principais demandas se referiram ao descumprimento de condicionalidade do Programa Bolsa Família (28,7%) e evasão escolar (26,4%). O serviço de saúde (33,3%) apresentou o maior encaminhamento intersetorial. A mediana do tempo de acompanhamento foi de 53 meses. Não houve diferença no tempo de acompanhamento em função do grupo etário, sexo, vínculo de trabalho informal ou precário, para recebimento de benefício, forma de acesso, tipo de demanda e registro de plano de acompanhamento (p≥0,272). A demanda espontânea foi a razão de a maioria das famílias estar em acompanhamento (86,2%), mas não havia registro sobre sua situação de vulnerabilidade. A identificação das famílias que necessitam de acompanhamento é importante para garantir acesso aos direitos socioassistenciais, além de contribuir para superar as desigualdades sociais existentes.

ABSTRACT The objective of this study was to describe the characteristics and demands of the families under follow-up at Social Assistance Referral Center (Cras) of Santa Marta, municipality of Belford Roxo, State of Rio de Janeiro, from 2006 to 2017. This is a descriptive cross-sectional study whose data were retrieved from the families' accompanying records. A total of 87 families were followed up within the study period. Most of the family heads were female (92.0%), under 40 (59.8%), single (92.0%) and incomplete elementary school (89.7%). Main demands referred to noncompliance with the Bolsa Família Program (28.7%) and school dropout (26.4%) conditionalities. Health service (33.3%) showed the greatest intersectoral referral. The median following-up time was 53 months. There was no difference in the following-up time due to the age group, gender, informal or precarious employment relationship, benefit payment, access type, demand type, and follow-up plan registration (p≥0,272). Spontaneous demand was the reason for most of the families to be under follow-up (86.2%), although no record existed on their vulnerability situation. The identification of the families in the need to be followed is important to guarantee access to social and care rights, besides contributing to overcome the existing social inequalities.

II. The research ethics involving vulnerable groups

Abstract Vulnerability in research occurs when the participant is incapable of protecting his or her interests and therefore, has an increased probability of being intentionally or unintentionally harmed. This manuscript aims to discuss the conditions that make a group vulnerable and the tools and requirements that can be used to reduce the ethical breaches when including them in research protocols. The vulnerability can be due either to an inability to understand and give informed consent or to unequal power relationships that hinder basic rights. Excluding subjects from research for the only reason of belonging to a vulnerable group is unethical and will bias the results of the investigation. To consider a subject or group as vulnerable depends on the context, and the investigator should evaluate each case individually.

Obstetric fistula: A challenge to public health

Obstetric fistula (OF) is one of the most important consequences of a prolonged obstructed labor, a big issue for low-income countries (LICs) like India. The objective is to identify and explore the knowledge regarding OF as a public health problem in LICs from peer review literature. The PubMed, Google Scholar, and Science Direct databases were searched to identify the prevalence, risk factors, and management of OF in LICs. Quantitative evidence-based paper reviewed. Twenty-seven articles met the inclusion criteria. The 15 provided population-based OF prevalence data of OF and 12 provided risk factors and social causes of OF rates associated with the birth that caused an OF. OF has one of the big public health problems. There is a lack of scientific research on the prevalence and risk factors of OF in LICs. This review helps to eradicate or alleviate the problem of OF in LICs like India.

Smokeless tobacco taxation: Lessons from Southeast Asia

Southeast Asia accounts for nearly 86 per cent of the smokeless tobacco (SLT) consumers in the world. The heterogeneous nature of SLT is a major impediment to using taxation as a tool to regulate SLT. This study was aimed to review issues around fiscal policies on SLT with the objective of providing clarity on the use of taxation as an effective policy instrument to regulate SLT use. Descriptive statistics and graphical representations were used to analyze published data from different sources. An analysis of prices and tax between smoke and SLT products was done to understand the impact of tax policies on SLT consumption. India, Bangladesh and Myanmar together account for 71 per cent of the world SLT users. The retail prices (PPP$) and tax were lower for SLT in low- and lower-middle-income countries and higher in high-income countries, on an average, suggesting a direct relationship between the two. Evidence from India and Bangladesh suggested that taxation had significantly reduced SLT use among adults. The compounded levy scheme used in India to tax SLT was found effective after incorporating speed of packing machines into the assessment of deemed production and tax on SLT products. The current analysis shows that taxation can be an effective instrument to regulate SLT consumption if tax rates are harmonized across SLT products and in a manner not to encourage substitution with other tobacco products. It is also imperative to set a minimum floor price on all tobacco products including SLT.

Vitamin A nutritional status in high- and low-income postpartum women and its effect on colostrum and the requirements of the term newborn / Estado nutricional de vitamina A de puérperas de alta e baixa renda e seu efeito sobre o colostro e a necessidade do recém-nascido a termo

Abstract Objective To evaluate the vitamin A status in serum and colostrum of postpartum women with different socioeconomic status, comparing the colostrum retinol supply with the vitamin A requirement of the newborn. Methods Cross-sectional study conducted with 424 postpartum women. Vitamin A maternal dietary intake was estimated using a food frequency questionnaire. Colostrum and serum retinol levels were measured by high performance liquid chromatography (HPLC). Serum retinol concentrations <20 µg/dL were indicative of vitamin A deficiency (VAD). Vitamin A levels provided by colostrum <400 µgRAE/day were considered as insufficient for term newborns. Results The mean maternal vitamin A intake during pregnancy was 872.2 ± 639.2 µgRAE/day in low-income women and 1169.2 ± 695.2 µgRAE/day for high-income women (p < 0.005). The prevalence of vitamin A deficiency was 6.9% (n = 18) in the low-income group and 3.7% (n = 6) in the high-income group. The estimated mean retinol intake by infants of the high- and low-income mothers were 343.3 µgRAE/day (85.8% AI) and 427.2 µgRAE/day (106.8% AI), respectively. Conclusions Serum vitamin A deficiency was considered a mild public health problem in both populations; however, newborns of low-income women were more likely to receive lower retinol levels through colostrum when compared with newborns of high-income mothers.

Resumo Objetivo Avaliar o estado nutricional de vitamina A no soro e colostro de puérperas com diferentes condições de renda, comparando os níveis de retinol fornecido através do colostro coma necessidade de vitamina A do recém-nascido. Métodos Estudo transversal com 424 mulheres pós-parto. A ingestão de vitamina A dietética pelas mães foi estimada através de um questionário de frequência do consumo alimentar. Os níveis retinol no soro e colostro foram quantificados por cromatografia líquida de alta eficiência (CLAE). Concentrações de retinol <20 µg/dL no soro foram indicativas de vitamin A deficiency. Os níveis de vitamina A fornecidas pelo colostro < 400 µg/RAE/dia foram considerados insuficientespara os recém-nascidos a termo. Resultados A ingestão média de vitamina A das mães durante a gravidez foi de 872,2 ± 639,2 µgRAE/dia em mulheres de baixa renda e 1169,2 ± 695,2 µgRAE/dia em mulheresde alta renda (p < 0,005). A prevalência de vitamin A deficiency foi de 6,9% (n = 18) no grupo de baixa renda e de 3,7% (n = 6) no grupo de alta renda. A estimativa dos valores médios de ingestão de retinol por lactentes de mães de baixa e alta renda foi de 343,3 µg/RAE/dia (85,8%AI) e 427,2 µg/RAE/dia (106,8% AI), respectivamente. Conclusões A vitamin A deficiency no soro foi prevalente em ambas as populações, entretanto, recém-nascidos de mães de baixa renda foram mais propensos a receberem níveis inferiores de retinol no colostro em comparação com recém-nascidos de mães de alta renda.

Echinococcosis and other parasitic infections in domestic dogs from urban areas of an argentinean Patagonian city

In urban populations of South America, dogs with free access to public areas represent a public health concern. The primary consequence of roaming dogs on human health is the transmission of infectious and parasitic diseases mainly through feces contamination. The main diseases likely to be transmitted are hydatidosis or echinococcosis, larva migrans, and giardiasis. In Argentina, hydatidosis ranks among the most prevalent zoonosis. Although it is considered a rural disease, the circulation of this parasite in urban areas has been documented. The aim of this work was to survey intestinal parasites in canine feces from two low-income urban neighborhoods of Bariloche city, Argentina, and to assess their seasonal variation. During 2016, 188 fresh dog feces were collected from sidewalks in 40 randomly selected blocks from the neighborhoods. Each sample was processed by Sheater flotation and tested for a coproantigen (CAg) by ELISA. The percentage of parasitized feces was 65.3% (95% CI: 55.9%-73.8%). Eleven parasite species were found, 3 protozoan, 3 cestodes, and 5 nematodes. Echinococcus sp. was present in 9.3% of the samples (95% CI: 4.7%-16.1%). Canine echinococcosis rates resulted similar to rates found previously in other neighborhoods of the city. The life cycle of Echinococcus sp. is sustained in urban areas by the entry of parasitized livestock, domiciliary slaughtering, and inadequate deposition of offal. The risk of Echinococcus sp. transmission to people in these neighborhoods is very high, due to high density of free-roaming dogs and high percentages of infected feces, similar to percentages observed in rural areas.

En las poblaciones urbanas de América del Sur, los perros con acceso libre a áreas públicas representan un problema de salud pública. La principal consecuencia es la transmisión de enfermedades infecciosas y parasitarias a través de la contaminación por heces. Las principales enfermedades que pueden transmitirse son hidatidosis, larva migrans y giardiasis. En Argentina, la hidatidosis es una de las zoonosis más prevalentes y aunque es considerada una enfermedad rural, algunos estudios muestran la circulación de este parásito en zonas urbanas. El objetivo fue registrar los parásitos intestinales en heces caninas de dos barrios de bajos ingresos de la ciudad de Bariloche, Argentina, y evaluar su variación estacional. Durante 2016, se recolectaron 188 heces frescas de perros en 40 manzanas seleccionados aleatoriamente. Las heces se procesaron mediante flotación de Sheater y una prueba ELISA de coproantigeno (CAg). El porcentaje de heces parasitadas fue del 65.3% (IC 95%: 55.9%-73.8%). Se encontraron 11 especies de parásitos, 3 protozoos, 3 cestodes y 5 nematodes. Echinococcus sp. estuvo presente en el 9.3% de las heces (IC 95%: 4.7% -16.1%). La equinococosis canina mostró valores similares a estudios previos en otros barrios de la ciudad. El ciclo de vida Echinococcus sp. se mantiene en las zonas urbanas por entrada de ganado parasitado, faena domiciliaria y deposición inadecuada de vísceras. El riesgo de transmisión de Echinococcus sp. en estos barrios es alto, debido a la alta densidad de perros sueltos y al alto porcentaje de heces infectadas, similar al de las zonas rurales.

Low-income youth and long-term school permanence: the senses built up by Prouni scholarship holders in Belo Horizonte (MG) / Juventude pobre e longevidade escolar: sentidos construídos por bolsistas do Prouni em Belo Horizonte (MG) / Juventud pobre y longevidad escolar: sentidos construidos por becarios del Prouni en Belo Horizonte (MG)

This article is derived from a doctoral research carried out in Belo Horizonte (MG), aiming at learning and understanding the senses low-income youths, who are Prouni (University for All Program) scholarship holders, set up concerning long-term school permanence. The qualitative study is anchored in the theoretical-methodological principles of Socio-Historical Psychology, which emphasizes the constitution of the subject in the socio-historical context, in addition to the subjects' activity as potential changers of their own context. In order to understand low-income youths' unique experience of long-term school permanence, we present the notion of youth as a plural category, as well as the Prounischolarship holders' life contexts, and the senses they develop based on their own experience as university students, which we collected using semi-structured interviews.

O presente artigo é derivado de pesquisa de doutoramento realizada em Belo Horizonte (MG), cujo objetivo foi apreender e compreender os sentidos que os jovens pobres, bolsistas do Programa Universidade para Todos (Prouni) constroem para a longevidade escolar. O estudo qualitativo foi ancorado nos princípios teórico-metodológicos da Psicologia Sócio-Histórica, que enfatiza a constituição do sujeito no contexto sócio-histórico, bem como a atividade do sujeito como potencialmente transformadora do próprio contexto. Para a compreensão da vivência singular da longevidade escolar dos jovens pobres, apresentamos a noção de juventude como uma categoria plural, os contextos de vida dos jovens bolsistas do Prouni e os sentidos que eles constroem para a própria experiência de estudantes universitários, que buscamos apreender por meio da realização de entrevistas semiestruturadas.

El presente artículo se deriva de la investigación de doctorado realizada en Belo Horizonte (MG), cuyo objetivo fue aprehender y comprender los sentidos que los jóvenes pobres, becarios del Programa Universidad para Todos (Prouni) construyen para la longevidad escolar. El estudio cualitativo fue anclado en los principios teórico-metodológicos de la Psicología Socio-Histórica, que enfatiza la constitución del sujeto en el contexto socio-histórico, así como la actividad del sujeto como potencialmente transformadora del propio contexto. Para la comprensión de la vivencia singular de la longevidad escolar de los jóvenes pobres, presentamos la noción de juventud como una categoría plural, los contextos de vida de los jóvenes becarios del Prouni y los sentidos que ellos construyen para la propia experiencia de estudiantes universitarios, que buscamos aprehender por medio de la realización de entrevistas semiestructuradas.

French Health Insurance for Low-income Group and Its Experience Enlightenment / 中国卫生经济

There were variety fragment characteristics in French medical insurance since its establishment.However,through introducing medical assistance mechanism in medical insurance system in France,it established medical treatment popularity and supplement medical assistance allowance system,guaranteed low-income group could get guarantee level for equal right.According to French experience,Chinese medical insurance system development should avoid welfare tendency,lead public resources to low-income and health expending poor families,gradually integrate assistance management resources and economic resources,conduct overall plan and comprehensive construction medical insurance plan among low-income group.

French Health Insurance for Low-income Group and Its Experience Enlightenment / 中国卫生经济

There were variety fragment characteristics in French medical insurance since its establishment.However,through introducing medical assistance mechanism in medical insurance system in France,it established medical treatment popularity and supplement medical assistance allowance system,guaranteed low-income group could get guarantee level for equal right.According to French experience,Chinese medical insurance system development should avoid welfare tendency,lead public resources to low-income and health expending poor families,gradually integrate assistance management resources and economic resources,conduct overall plan and comprehensive construction medical insurance plan among low-income group.

Nutritional Status of Under-five Children from Urban Low-income Families in Xiangtan and Jilin in China / 华中科技大学学报（医学）（英德文版）

There have been many studies on the nutrition and the growth status of children from rural and remote western regions of China,whereas researches on children from urban low-income families are scarce.This study aimed to investigate the growth and nutritional status of children under five years of age from urban low-income families in China.There were 169 children aged 25-60 months recruited from Xiangtan and Jilin,two cities with a population of 2.81 million and 4.26 million respectively,in China in this cluster cross-sectional study.Data were collected on demographic and socioeconomic characteristics,the feeding practices and the incidence of anemia and diarrhea.The results showed that the prevalence of low birth weight and macrosomia was 7.l％ and 9.5％ for the two cities,respectively,which was higher than that for other cities in China (1.5％ and 5.9％).Of all the sampled children,14.6％ and 8.2％ suffered anemia and diarrhea,respectively.Multivariate analysis showed that legumes or nuts fed in a 24-h recall increased the risk of anemia (OR=4.9).Children whose caregivers began to introduce complementary foods relatively late would have high diarrhea prevalence (OR=1.4).In conclusion,the prevalence of anemia and diarrhea in under-five children from urban low-income families in China is relatively high.The growth and nutritional status of these children is greatly affected by feeding practices.A series of measures should be taken by relevant government departments to improve the health of these children.

“I'm healthy, I don't have pain”- health screening participation and its association with chronic pain in a low socioeconomic status Singaporean population

BACKGROUND: We sought to determine the association between chronic pain and participating in routine health screening in a low socioeconomic-status (SES) rental-flat community in Singapore. In Singapore, ≥ 85% own homes; public rental flats are reserved for those with low-income. METHODS: Chronic pain was defined as pain ≥ 3 months. From 2009−2014, residents aged 40−60 years in five public rental-flat enclaves were surveyed for chronic pain; participation in health screening was also measured. We compared them to residents staying in adjacent owner-occupied public housing. We also conducted a qualitative study to better understand the relationship between chronic pain and health screening participation amongst residents in these low-SES enclaves. RESULTS: In the rental-flat population, chronic pain was associated with higher participation in screening for diabetes (aOR = 2.11, CI = 1.36−3.27, P < 0.001), dyslipidemia (aOR = 2.06, CI = 1.25−3.39, P = 0.005), colorectal cancer (aOR = 2.28, CI = 1.18−4.40, P = 0.014), cervical cancer (aOR = 2.65, CI = 1.34−5.23, P = 0.005) and breast cancer (aOR = 3.52, CI = 1.94−6.41, P < 0.001); this association was not present in the owner-occupied population. Three main themes emerged from our qualitative analysis of the link between chronic pain and screening participation: pain as an association of “major illness”; screening as a search for answers to pain; and labelling pain as an end in itself. CONCLUSIONS: Chronic pain was associated with higher cardiovascular and cancer screening participation in the low-SES population. In low-SES populations with limited access to pain management services, chronic pain issues may surface during routine health screening.